Author: Dana C. Leighton, Ph.D.

An interesting article in Prospect Magazine examines the difficult choices psychiatrists have to make when prescribing treatments for mental disorders. (thanks to Mind Hacks for pointing this out) The thesis of the article (that fat is not beautiful) is troubling, but in any event, the rest is quite good. It’s a story of a teenager with early-onset psychosis…

Her story: ‘Beautiful madness’ by Alexander Linklater | Prospect Magazine February 2006 issue 119:

Nia had revealed little to her parents of what was really going on inside her head. But the soft-spoken psychiatrist at the local adolescent mental health centre won her confidence and she began to tell him about the trains. A railway line ran a few hundred yards past the bottom of their garden, far enough away for the family to ignore it. Nevertheless, Nia said she could hear people talking about her inside the painted steel carriages. In the clank of heavy rolling stock she could pick out snatches of conversations about her—derogatory insinuations that crept into her room through the plastic veneer of the double-glazing. She also told him that she had seen things on television. The newsreaders had begun looking at her. In the corners of their eyes she began to read signs. They were sending her messages; messages that linked up with the voices on the trains.

…

The consultant favoured Olanzapine for Nia; he had found the drug to work well in her age group despite concerns about weight gain and diabetes. Other modern choices include Quetiapine, though many clinicians think it a weaker drug, and Risperidone, which can also cause weight gain and stiffness. The older drugs like Chlorpromazine and Haloperidol were felt to be “dirtier” and to have worse side effects, including the irreversible lip-smacking and protruding tongue movements of tardive dyskinesia. Seasoned sceptics argue that not much, fundamentally, has changed since the 1950s, apart from refining the choice of side-effects. The young psychiatrist wrote Nia up for Olanzapine—10mg, the regular dose. The drug being a sedative, Nia took it at night. She began to sleep.

Not much changed for five days. Then, one morning, Nia was transformed. She left her bedroom, came to meals, had normal conversations with staff. Her face filled out with ordinary human expressions. A day later she was even laughing. A young woman, an intelligent teenager, had reappeared; the psychosis seemed to have left her.

Technorati Tags: abnormal psychology, Mental health, psychology

I have been perusing The Politics of the Family lately. R. D. Laing was among a few authors to examine the structures we live in, and how those structures may support, or perhaps even bring about, mental illness. For the most part, his propositions and logical puzzles are sound, although he goes out on some limbs that require quite a number of assumptions to be satisfied in order to accept the proposition. Laing comes up with some really quite good quotes in this book of essays. Have a look at these:

Referring to families in which there is resistance to realizing the dysfunction they inure:

Between truth and lie are images and ideas we imagine and think are real, that paralyze our imaginations and our thinking in an effort to conserve them. (from Family Scenarios, pp. 77)

Referring to the ways we take on the (often dysfunctional) roles of ancestors in our families, he says:

There are usually great resistances against the process of mapping the past onto the future coming to light, in any circumstances. If anyone in a family begins to realize he is a shadow of a puppet, he will be wise to exercise the greatest precautions as to whom he imparts this information to.

It is not ‘normal’ to realize such things. There are a number of psychiatric names, and a variety of treatments, for such realizations. (from Family Scenarios, pp. 82)

Referring to the ways in which many of us seem to be in a form of “waking hypnosis,” he writes:

We are acting parts in a play that we have never read and never seen, whose plot we don’t know, whose existence we can glimpse, but whose beginning and end are beyond our present imagination and conception. (from Family Scenarios, pp. 87)

Referring to Freud’s concept of (sexual) repression, he writes:

One is expected to be capable of passion, once married, but not to have experienced too much passion (let alone acted upon it) too much before. If this is too difficult, one has to pretend first not to feel the passion one really feels, then, to pretend to passion one does not really feel, and to pretend that certain passionate upsurges of resentment, hatred, envy, are unreal, or don’t happen, or are something else. This requires false realizations, false de-realizations, and a cover-story (rationalization). After this almost complete holocaust of one’s experience on the alter of conformity, one is liable to feel somewhat empty, but one can try to fill one’s emptiness with money, consumer goods, … narcotics, stimulants, sedatives, … to depress one further so that one does not know how depressed one is and to help one to over-eat and over-sleep. And there are lines of defence beyond that, to electroshocks, to the (almost) final solution of simply removing sections of the offending body, especially the central nervous system. This last solution is necessary, however, only if the normal social lobotomy does not work, and chemical lobotomy has also failed. (from Operations, pp. 101)

He takes a swipe at growing up in Scotland with this one:

No one intended, when they told a little boy when and how to clean his teeth, and that his teeth would fall out if he was bad, together with Presbyterian Sunday School and all the rest of it, to produce forty-five years later the picture of a typical obsessive involutional depression. This syndrome is one of the specialties of Scotland. (from Rules and Metarules, pp. 109)

Referring to the social rules that prohibit thinking or mentioning taboo subjects, he writes:

I have thought about the problem of how not to think a thought one is not supposed to think. I cannot think of any way to do so except, in some peculiar way, to ‘think’ what one must not think in order to ensure that one does not think it. (from Rules and Metarules, pp. 115).

Laing, R. D. (1971). The politics of the family and other essays. New York: Pantheon Books.

Technorati Tags: abnormal psychology, psychology, social criticism